Hysteroscopy #8

Yesterday was hysteroscopy number 8. This was the 'third strike and you're (uterus is) out!' hysteroscopy. My OB just called to report that there were lots of calcifications and other 'crud' in my uterus. She can still see the holes from the clerclage, which I guess aren't healing well. Further, the pathology continues to show infection.

So I do another round of clindamaycin. Followed by a SIS and biopsy. And then we talk about next steps.

I got off the phone and snuggled babies, because, really, what else can you do after a call like that? Fortunately, these two make it so worthwhile!

A, being entirely adorable and happy.

T, making faces

AYFKM?!?

This has been a week of "are you effing kidding me?", but today sealed the deal. Warning, complaining ahead!

People say having kids is expensive. I hadn't quite realized the breadth of those expenses! The day we brought A home, our central heat died. In Minnesota. Two days before a snow storm.

The day we brought Tess home, our fridge died. With all my frozen breast milk inside.

After that, we looked hard at our infrastructure and decided that our decrepit washer and dryer should be replaced before they left us stranded and desperate with baby laundry. So we bought a fancy new set. Delivered Saturday before last. Would you like to guess what died yesterday? The dryer. The brand new dryer. Repair people will be out for their earliest appointment, next week. AYFKM?

Today was my hysteroscopy follow up. We did an ultrasound to check IUD placement. Result? There is STILL RPOC in my uterus AND my IUD has migrated and lodged in my cervix. AYFKM?

OB gave me four options, ranging from " do nothing and hope no infection sets in"  to "hysterectomy." Well, fuck. We're taking the middle approach of removing the IUD and doing another hysteroscopy to clear the RPOC. If this one still doesn't work, we'll talk hysterectomy.

I'm really ready for some good news. Please share your happy thoughts with me as I could certainly use them!

Microblog Monday: Something Ugly

Welcome to Microblog Mondays! Want to learn more and read more? Head over to Stirrup Queens for the details!

I've tried to be honest in this blog, even about ugly subjects. I feel the need to address one of the ugliest: gender disappointment. I was open during Alexis and Zoe's pregnancy that I preferred girls, and part of my unmitigated joy during their pregnancy was because they were both female.

When I got pregnant with Quinn, I spent the first 12 weeks convinced I was having a boy. There was a constant,  almost physically painful disappointment associated. I felt gutted that I'd gone from a pregnancy that was everything I could have dreamed of - twin girls - to something less - a single boy. Finding out Quinn was a girl brought the most amazing relief and joy. I sobbed sharing the news with family.

Oddly enough, this pregnancy I didn't feel the same level of worry about the babies' sexes. I had a preference for girls, but there wasn't the almost physical need to have two girls that I'd felt with Quinn. Likewise, there wasn't the deep preference I'd felt with Alexis and Zoe. I have no idea what changed, but something did.

The only time I felt really upset about the babies' sexes was when people would comment on how great it would be to "have one of each." I always wanted to respond that it would have been even greater to have the two girls we initially expected and wanted.

Now that the babies are here, there is zero disappointment. Zero regret about having "one of each" rather than two girls. While I can remember how many emotions related to my pregnancies felt, I can't even bring back the feeling of wanting only girls. I can bring back the fear from past pregnancies. I can bring back the grief over loss and NICU time. I can bring back the uncertainty if I'd ever get pregnant, or the anger over DH's SCSA results. I can't bring back anything related to gender disappointment. My family feels absolutely perfect the way it is.

Sometimes things go horribly wrong and work out in ways that are unexpectedly heart wrenching. I think I had forgotten that sometimes they go right and work out in ways that are unexpectedly heartwarming. I am thrilled that the babies I've got fall under the later category.

Remembrance

Earlier today, DH and I attended the Day of Pediatric Remembrance at the U of M's Masonic Children's Hospital. It's an event held for the families of children treated at the U of M who have passed in recent years. We were invited because that's where Quinn was born. When I RSVP'd, I also mentioned we needed to recognize Alexis and Zoe, and they were included in the program.

Let's just say that the day gave me all the feels.

We saw the social worker and chaplain that we knew from both our recent hospitalizations and from our time with Quinn. They both asked about A & T, and both told us that as soon as they saw my  name on the roster at Southdale, they checked in with Dr. Y to see what my status was. After the service was over they asked to see pictures of A & T. They recognized both the pain of our loss and the joy of A & T in a meaningful way. I was beyond touched, and so, so happy to see these two amazing women again.

It also felt wonderful to honor Alexis, Zoe, and Quinn. The last 14 weeks have been so focused on A & T that I was glad to spend some time on our other girls.

The rest. . . the rest was hard. Grief feels so isolating, so lonely. While DH has been amazing, and I've met other incredible loss moms who inspire me, I've often felt alone in my pain. During the program, each family shared a photo of their child. They ranged from NICU babies to late teens. Every one was absolutely beautiful and full of life in their photos. Being there with other families, seeing photos of their children reminded me of how much company we have. We are clearly not alone. That was both comforting and deeply heartbreaking as we stared at those photos of precious children who are no longer here.

How I wish we lived in a world where a day like this was unnecessary. However I'm very grateful to the U of M team for making this happen in the reality we do live in.

Forgiveness After Loss

I mentioned struggling emotionally while in the NICU. That's not the only way I've struggled. Life after loss is complex. There are so many conflicting emotions. My biggest struggle is how to look at past versus present.

I look at A and T and I love them so much. I can't imagine not having them in my life, getting to see them become the people they are going to be. I am so utterly grateful to get this chance. And yet, if Alexis and Zoe, or Quinn had survived, A and T would never have been born. So being completely grateful for them leaves me feeling disloyal to their big sisters.

At the same time, I can't bring myself to wish that A & T weren't here, because they are and I love them more than anything. It feels that no matter how I look at things, I'm being hurtful to some of my children: either Alexis, Zoe, and Quinn if I'm unreservedly happy about A and T, or to A and T if I feel sadness that I'm not getting to experience raising their big sisters.

I know this is all guilt I'm foisting upon myself, but I don't have a resolution for it. Maybe I don't need one, either. Maybe the reality is that life after loss is complex, and emotions are complex, and it's ok to feel what you feel. Maybe someday I'll believe that enough to forgive myself for those feelings.

Breast May Not Be Best

Going into this pregnancy, I knew that I really wanted to try to breastfeed. Every woman I personally know who has breastfed says it's incredibly hard and quite painful, especially at first. Most of them also say it's rewarding if you can make it through. Plenty of women on the internet seem to claim that pain is a sign 'you're doing it wrong', but I call B.S. on that!

So, we gave it a shot.

Due to their prematurity, the babies couldn't breastfeed, even attempt it, until about 33 weeks, so I pumped at first. At around 33.5 weeks, T started showing signs of cuing, so we tried breastfeeding. I was still in intense pain from my digestive system, especially when sitting upright, which complicated matters.

At the recommendation of the lactation consultant, I used a nipple shield. The process to breastfeed was awful. First a nurse would weigh the baby. I'd grit my teeth against the pain and sit upright. Using both hands, I'd place the nipple shield to draw my inverted nipples into it, then hand express milk into it. Once I was ready, I'd be passed the baby with all their monitoring wires attached. At that point, I'd try to get them to latch. T would latch then scream, twist her head back and forth, and tear the shield off my breast. That would send the expressed milk spilling down my front/bra, and I'd have to replace the shield and hand express more milk one handed, while holding her with the other. Not easy. Eventually she'd start sucking, but always after chomping down on my nipples at least once. Who knew gums could hurt so much? A would latch, then lay there looking up at me and never suck.

Those internet women who say breastfeeding shouldn't be painful? They often say you need the baby to have a wide latch. "Get the areola fully in the baby's mouth." Yeah, right. You try managing that while trying to hold on a nipple shield and working with a preemie whose mouth is the size of a dime!

Once we'd spent 15-20 minutes at this, the nurse would take her back and re-weigh her. One of the most crushing moments of our entire 8 week hospital stay was when they took her back, by which point I was shaking with pain from sitting upright, and told me she'd LOST a gram. Let me tell you, it's brutal to do something that hurts so badly, feel like you're torturing your child the entire time due to the screaming, and then find out you accomplished worse than nothing!

Over the course of 8 weeks, the best we ever transferred was 27 mls, which was half of the needed amount at the time. Since I needed to empty my breasts to keep building my supply, that meant I still needed to pump. Given my pain level from sitting up, eventually I started to prioritize pumping over attempting to breastfeed.

Pumping has been nearly as tough, although I can happily report that my pump doesn't ever scream at me when I put it to breast! My supply has hovered at 50-66% of what the babies need, despite everything I've tried to increase it. I power pumped for days on end. I tried pumping every 2 hours around the clock for 4 straight days. I tried drinking more, sleeping more, sleeping less. Hell, I even tried coconut water! No increase. I suspect this is partially due to all the retained placenta I had, but the surgery to remove it hasn't done much to increase my supply, so who knows?

I also have a great deal of nipple pain. Unless I'm in a hot shower or under a heating pad, my nipples constantly feel like they're being stabbed by needles. They often turn white or purple. My OB suspects that this is due to my Raynaud's syndrome, which apparently impacts breast tissue and not just hands and feet. WTF, body? Can you do nothing helpful? Apparently the answer is no.

I have a goal of 6 months of pumping. We all know I'm stubborn, so we'll see if I make it or not.

Scheduling my Breakdown

I've talked about NICU logistics. That's ignored the elephant in the room, tho: NICU emotions. Every single day we were in the hospital, each time I would lay down in my hospital bed to get a few minutes of sleep, I would think to myself that I wanted nothing more than to start sobbing and just break down for a while. And each time that happened, I would tell myself that it would be OK to cry, OK to let it all out, but not just yet. I'd tell myself I just needed to wait a bit longer. I told myself I could schedule my breakdown for sometime when we were out of the NICU.

Why did I need that outlet so much? Why did I want to sob so badly, night after night for weeks? Well, my life long habit is to do a quick mental evaluation of how things are going before sleep each day. During the NICU stay, the answer was that every single thing related to my pregnancy, to my delivery, to the babies, and to my recovery was not what I'd hoped for, except for the most critical thing: my babies were alive and would someday come home.

It feels awful to complain about how 'bad' things were, when I knew A and T would be ok. Yet, the pregnancy was completely awful, as was what followed. I didn't get to hold my daughter for nearly a week. I didn't get to hold my son for nearly 24 hours. I was in so much pain that the thing I wanted most in life at that moment - to be with my babies constantly - was impossible. I didn't get to keep my babies safe. I had to watch them struggle and have medical interventions that were heartbreaking to see. Breastfeeding was a dud. I wasn't going to get to go home from the hospital with both my children. I had to introduce them to their grandparents amidst proof of flu shots and vats of hand sanitizer. Everything I might have hoped for, I didn't get. Except that they were alive. And that's really the crux, isn't it? I'd have given up any of those earlier hopes to have kept Alexis, Zoe, or Quinn alive. Thus, I was conflicted in the emotional pain I was feeling. Heck, I *still* am conflicted in the emotional pain I'm feeling.

The babies are 13 weeks now, and I  no longer feel like sobbing due to dashed hopes. I might feel like sobbing due to lack of sleep, but that's somehow relieving as that's "normal". Someday I'll try to work through these emotions, but for this moment, I'll enjoy the snuggles and the everyday moments with my kids and be beyond thankful that we're all home safe together.